Falls of the elderly are a major problem in institutional care. However, more comprehensive studies concerning the long-time survival of fallen institutionalised elderly are lacking. We investigated the 5-year survival of institutionalised elderly fallers and controls. Data of the patients aged over 60 years, who fell during the 1-year period (n=218) in four institutions were collected prospectively. The controls consisted of patients of the same age who did not fall within the same period (n=632). The survival of both groups was analysed by gender in the total data, and in the short-term (ST) and long-term (LT) patients separately. In addition, the survival of fallers was investigated according to the number of falls per patient. After follow-up, 164 (75%) fallers and 369 (58%) controls were dead. The female controls survived best and the survival of the male fallers was the poorest. The death rate was higher than expected among female fallers and lower than expected among female controls. The survival of the patients who fell twice during the 1-year period was clearly poorer than of those who fell once or three or more times. No difference in the survival rates was found between the injured and non-injured fallers. Falls in institutional care predict poor survival. The first and especially the second fall should be prevented.